NPI 1205275401

Medicare Providers Network, LLC

Organisation Exclusive Provider Organization Orlando, FL

Practice location

Address: 2840 N Hiawassee Rd STE # 428, Orlando, FL 32818-3319
Phone: (407) 921-2074
Fax: (407) 264-8686
Mailing address: PO Box 951659, Lake Mary, FL 32795-1659

Authorised official

Name: Jasvendar Singh Nandra
Title: Ceo
Phone: (407) 921-2074

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence ME85696 (FL)

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Registry record

NPI: 1205275401
Entity type: Organization
NPI issued: 20 Jun 2013
Record last updated: 20 Jun 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.